Your doctor will discuss your options for treatment, based on the type of uterine cancer you have as well as other factors. Basically, the choices may include:
SurgeryHormone medicationChemotherapyRadiationA combination of the above
Uterine Cancer Surgery
The main treatment for endometrial cancer is a hysterectomy, the removal of both the uterus and the cervix (the lower end of the uterus, near the vagina). In this surgery, the surgeon may also remove the ovaries and fallopian tubes (bilateral salpingo-oophorectomy). However, if you have not yet gone through menopause, you need to discuss with your doctor whether it would be better to preserve the ovaries. The removal of your ovaries can trigger premature menopause. Your doctor may also remove lymph nodes from the pelvic area to test for any cancer that may have spread outside of the uterus. Hysterectomies are done in different ways. In some, the uterus is removed through an abdominal incision (abdominal hysterectomy). Sometimes the uterus is removed through the vagina. Recovery time depends on the type of surgery and whether there are any complications. In general, however, it can take two to six weeks for recovery. Hospital stays also vary, from about three days to a week.
Hormone Therapy
If your doctor recommends hormone therapy, you will be given hormone medication that decreases the levels of hormones that your body makes, or blocks hormones from working. The goal of hormone therapy is to stop the cancer cells from growing.
Chemotherapy
The goal of chemotherapy is to prescribe medication to shrink or kill the cancer cells. Chemotherapy can be taken orally in pill form, or given to you intravenously — or sometimes both ways.
Radiation Therapy
If your doctor recommends radiation therapy, it may be given internally or externally. High-energy rays, somewhat like X-rays, are used to kill the cancer cells. Internal radiation, also called brachytherapy, is done in the radiology department of a hospital or cancer care center. This involves inserting a cylinder with a source of radiation (pellets) into the vagina. External beam radiation is typically given for four to six weeks, five days a week. You must be in the same position for each treatment so the radiation gets to the correct spot. If both types of radiation therapy are required, external beam radiation is often given first. If you are to undergo radiation after surgery, you will be given time to heal from the surgery first. That typically requires four to six weeks.
Uterine Cancer Prognosis and Survival Rate
When your doctor recommends a treatment plan, it’s wise to ask about the prognosis, or outlook, for each type of treatment. You can also inquire about any side effects of treatment. If you don’t feel comfortable with the answers, don’t hesitate to consult another doctor for a second opinion. When diagnosed early, women with uterine cancer have a very good prognosis, according to the American Cancer Society. For endometrial adenocarcinoma, a common type, those diagnosed at stage 1A have an 88 percent survival rate at five years. Those diagnosed with the highest stage, IVB, have a 15 percent survival rate. For uterine carcinosarcoma, the survival rate at five years is 70 percent, but drops to 15 percent for state IV, the highest stage. For this type of cancer, experts give what is called relative survival. The rates are based on the assumption that some people will die of other causes besides cancer, and compare the observed survival with that expected for those who don’t have cancer. To give you an idea of your prognosis, your doctor will review the survival statistics gathered for other women who have had the same type of uterine cancer. Remember that these are averages over the five years after diagnosis, and that some women do much better than average.
